Hospital leaders propose 8 care design principles to improve industry

The Patient Protection and Affordable Care Act has led to some progress in improving individual patient care, boosting the health of populations and lowering per capita costs of healthcare, but healthcare leaders need to do more, according to a viewpoint piece published in JAMA.

According to the authors of the report, laws, regulations and payment changes alone cannot fully realize the potential of the triple aim.

"Leaders involved in healthcare must be actively and directly involved in catalyzing change needed to achieve the triple aim," the authors wrote.

Healthcare leaders are able to adapt innovations to different geographical and demographical settings and do so faster than the pace of evolution of laws and regulations. They can also help achieve unprecedented improvements in care by soliciting trust and support and fostering authentic dialogue from their patients and the public in a way that insurers and the government cannot easily do.

According to the authors of the piece, reliable progress on the triple aim will require a revised set of care design principles, such as:

  • Designing and encouraging systems that prepare for and embrace change, in the continual pursuit of improvement
  • Changing the balance of power, so that health and well-being can be coproduced in partnership with patients, families and communities
  • Developing and rallying morale in the healthcare workforce
  • Continually reducing waste and all non-value-added requirements and activities for patients, families and clinicians
  • Exploiting the knowledge that exists in the modern digital age to substitute better alternatives for visits and institutional stays, such as telemedicine
  • Cooperating and collaborating across institutional and professional boundaries that impede flow and responsiveness
  • Using all the resources at hand, especially those brought by patients, families and communities
  • Returning the money from healthcare savings to other public and private purposes and aiming for total healthcare expenditures at or below 15 percent of gross domestic product

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